Assessment of a strategy for the control of respiratory diseases in children

A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

Integrated Management of Childhood Illness: efficiency of primary health in Northeast Brazil

OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy implementation at least two years before the start of study, with 48 matched comparison facilities in the same states. A single measure of correct management of sick children was used to assess care provided to all sick children. Costs included all resources at the national, state, local and facility levels associated with child health care. RESULTS: Facilities providing strategy-based care had significantly better management of sick children at no additional cost to municipalities relative to the comparison municipalities. At strategy facilities 72% of children were correctly managed compared with 56% in comparison facilities (p=0.001). The cost per child managed correctly was US$13.20 versus US$21.05 in the strategy and comparison municipalities, respectively, after standardization for population size. CONCLUSIONS: The strategy improves the efficiency of primary facilities in Northeastern Brazil. It leads to better health outcomes at no extra cost.

Nouvelles espèces d’ostracodes de l’Albien et du Cénomanien d’Estremadura (Portugal)

Examination of samples from eight outcrops from Albian and Cenomanian of Estremadura, induced to take a census of sixty-two species and subspecies of Ostracodes among which fifteen are new and described here. Their associations pennited - first, to characterize three faunistic sets: a lower and middle Albian set with a mediolittoral and infralittoral (shallow marine} sedimentation; an upper Albian s.l. (near formations of Rudists}; a lagoonal lower Cenomanian; - on the other hand, to state local comparisons with the middle Cretaceous of Southern France, of the South-pyrenean Zone (Sierra d' Aulet: district of Sopeira), of the district of Oviedo (Northwestern Spain), and of the Aragonese Iberian Range (Aragon and Maestrazgo), placing in a prominent position faunistic exchanges of Ostracodes between the above-mentioned regions and the Estremadura, during the lower Cenomanian.

Iowa Aviation Plan, 2004-2024

The Iowa Department of Transportation (DOT), working closely with the Federal Aviation Administration (FAA), strives to ensure that Iowa’s system of public airports is positioned to meet the needs of businesses, residents, and visitors to our state. Airports must be accessible and positioned to safely meet different levels of aviation activity. In partnership with the FAA and various cities, counties, and airport authorities, the Iowa DOT helps to direct the systematic development of public airports. This report is a summary of a more comprehensive technical report that outlines a strategic plan for improving the performance of airports in Iowa over the next 20 years. More information on the technical report and on individual reports prepared for each of the public airports can be obtained from the Iowa DOT, Office of Aviation website at www.iawings.com. The Iowa Aviation System Plan provides the Iowa DOT with an important tool to monitor the ability of airports to meet customer needs. The plan also provides a means to measure the effects of investment on the performance of the Iowa Aviation System. Over the next 20 years, federal, state, local, and private funding will be needed to ensure that the aviation system meets goals established in this study. It is estimated that at least $821 million will be needed over the next 20 years if airports in Iowa are to respond to objectives set by the system plan. In future years, the plan will enable the Iowa DOT to measure system performance. By tracking key indicators for the airport system, it will be possible for the Iowa DOT and the FAA to formulate strategies for responding to Iowa’s air transportation needs. The Iowa Aviation System Plan provides a guide for the state and its communities to ensure that the vision established for the Iowa Aviation System can be achieved.

Iowa Aviation Plan, 2004-2024

The Iowa Department of Transportation (DOT), working closely with the Federal Aviation Administration (FAA), strives to ensure that Iowa’s system of public airports is positioned to meet the needs of businesses, residents, and visitors to our state. Airports must be accessible and positioned to safely meet different levels of aviation activity. In partnership with the FAA and various cities, counties, and airport authorities, the Iowa DOT helps to direct the systematic development of public airports. This report is a summary of a more comprehensive technical report that outlines a strategic plan for improving the performance of airports in Iowa over the next 20 years. More information on the technical report and on individual reports prepared for each of the public airports can be obtained from the Iowa DOT, Office of Aviation website at www.iawings.com. The Iowa Aviation System Plan provides the Iowa DOT with an important tool to monitor the ability of airports to meet customer needs. The plan also provides a means to measure the effects of investment on the performance of the Iowa Aviation System. Over the next 20 years, federal, state, local, and private funding will be needed to ensure that the aviation system meets goals established in this study. It is estimated that at least $821 million will be needed over the next 20 years if airports in Iowa are to respond to objectives set by the system plan. In future years, the plan will enable the Iowa DOT to measure system performance. By tracking key indicators for the airport system, it will be possible for the Iowa DOT and the FAA to formulate strategies for responding to Iowa’s air transportation needs. The Iowa Aviation System Plan provides a guide for the state and its communities to ensure that the vision established for the Iowa Aviation System can be achieved.

Iowa Aviation System Plan, 2004-2024

The Iowa Department of Transportation (DOT), working closely with the Federal Aviation Administration (FAA), strives to ensure that Iowa’s system of public airports is positioned to meet the needs of businesses, residents, and visitors to our state. Airports must be accessible and positioned to safely meet different levels of aviation activity. In partnership with the FAA and various cities, counties, and airport authorities, the Iowa DOT helps to direct the systematic development of public airports. This report is a summary of a more comprehensive technical report that outlines a strategic plan for improving the performance of airports in Iowa over the next 20 years. More information on the technical report and on individual reports prepared for each of the public airports can be obtained from the Iowa DOT, Office of Aviation website at www.iawings.com. The Iowa Aviation System Plan provides the Iowa DOT with an important tool to monitor the ability of airports to meet customer needs. The plan also provides a means to measure the effects of investment on the performance of the Iowa Aviation System. Over the next 20 years, federal, state, local, and private funding will be needed to ensure that the aviation system meets goals established in this study. It is estimated that at least $821 million will be needed over the next 20 years if airports in Iowa are to respond to objectives set by the system plan. In future years, the plan will enable the Iowa DOT to measure system performance. By tracking key indicators for the airport system, it will be possible for the Iowa DOT and the FAA to formulate strategies for responding to Iowa’s air transportation needs. The Iowa Aviation System Plan provides a guide for the state and its communities to ensure that the vision established for the Iowa Aviation System can be achieved.

Iowa Problem Identification, February 2010

Each year, traffic crashes in the United States result in nearly 300,000 deaths and serious injuries. In 2008 alone, traffic crashes cost the nation an estimated $230 billion, nine times more than the estimated cost of all crime. Highway crashes represent the leading cause of death and disabling injury for persons under age 35. In recognition of this problem, the Congress of the United States enacted national highway safety legislation in 1966, which led to the establishment of the National Highway Traffic Safety Administration (NHTSA). The legislation also provided for federal highway safety monies to be made available to the states with a goal of reducing death and injury on the nation’s roads. Iowa has been very active in the federal-state local highway safety partnership since the mid 1960s.

The prediction of seasonal and inter-annual climate variations and their impacts on the water resources in the eastern seaboard of Thailand

The research of this thesis dissertation covers developments and applications of short-and long-term climate predictions. The short-term prediction emphasizes monthly and seasonal climate, i.e. forecasting from up to the next month over a season to up to a year or so. The long-term predictions pertain to the analysis of inter-annual- and decadal climate variations over the whole 21st century. These two climate prediction methods are validated and applied in the study area, namely, Khlong Yai (KY) water basin located in the eastern seaboard of Thailand which is a major industrial zone of the country and which has been suffering from severe drought and water shortage in recent years. Since water resources are essential for the further industrial development in this region, a thorough analysis of the potential climate change with its subsequent impact on the water supply in the area is at the heart of this thesis research. The short-term forecast of the next-season climate, such as temperatures and rainfall, offers a potential general guideline for water management and reservoir operation. To that avail, statistical models based on autoregressive techniques, i.e., AR-, ARIMA- and ARIMAex-, which includes additional external regressors, and multiple linear regression- (MLR) models, are developed and applied in the study region. Teleconnections between ocean states and the local climate are investigated and used as extra external predictors in the ARIMAex- and the MLR-model and shown to enhance the accuracy of the short-term predictions significantly. However, as the ocean state – local climate teleconnective relationships provide only a one- to four-month ahead lead time, the ocean state indices can support only a one-season-ahead forecast. Hence, GCM- climate predictors are also suggested as an additional predictor-set for a more reliable and somewhat longer short-term forecast. For the preparation of “pre-warning” information for up-coming possible future climate change with potential adverse hydrological impacts in the study region, the long-term climate prediction methodology is applied. The latter is based on the downscaling of climate predictions from several single- and multi-domain GCMs, using the two well-known downscaling methods SDSM and LARS-WG and a newly developed MLR-downscaling technique that allows the incorporation of a multitude of monthly or daily climate predictors from one- or several (multi-domain) parent GCMs. The numerous downscaling experiments indicate that the MLR- method is more accurate than SDSM and LARS-WG in predicting the recent past 20th-century (1971-2000) long-term monthly climate in the region. The MLR-model is, consequently, then employed to downscale 21st-century GCM- climate predictions under SRES-scenarios A1B, A2 and B1. However, since the hydrological watershed model requires daily-scale climate input data, a new stochastic daily climate generator is developed to rescale monthly observed or predicted climate series to daily series, while adhering to the statistical and geospatial distributional attributes of observed (past) daily climate series in the calibration phase. Employing this daily climate generator, 30 realizations of future daily climate series from downscaled monthly GCM-climate predictor sets are produced and used as input in the SWAT- distributed watershed model, to simulate future streamflow and other hydrological water budget components in the study region in a multi-realization manner. In addition to a general examination of the future changes of the hydrological regime in the KY-basin, potential future changes of the water budgets of three main reservoirs in the basin are analysed, as these are a major source of water supply in the study region. The results of the long-term 21st-century downscaled climate predictions provide evidence that, compared with the past 20th-reference period, the future climate in the study area will be more extreme, particularly, for SRES A1B. Thus, the temperatures will be higher and exhibit larger fluctuations. Although the future intensity of the rainfall is nearly constant, its spatial distribution across the region is partially changing. There is further evidence that the sequential rainfall occurrence will be decreased, so that short periods of high intensities will be followed by longer dry spells. This change in the sequential rainfall pattern will also lead to seasonal reductions of the streamflow and seasonal changes (decreases) of the water storage in the reservoirs. In any case, these predicted future climate changes with their hydrological impacts should encourage water planner and policy makers to develop adaptation strategies to properly handle the future water supply in this area, following the guidelines suggested in this study.

Coopetencia y modelos de asociatividad en colombia

El concepto de coopetencia surgen los planteamientos relacionados con los clústers y las redes empresariales, en donde empresas con características similares fortalecen sus relaciones para desarrollar mayores niveles de eficiencia o alcanzar objetivos que individualmente serian difíciles de lograr, especialmente en el caso de las pymes. Es fundamental que el estado desarrolle las relaciones y la conformación de iniciativas de asociatividad que permitan que la fluidez y los vínculos entre empresas, instituciones gubernamentales, financieras, universidades, centros de investigación, entre otros; para promover la integración de esfuerzos, la fluidez de información y el acceso a tecnologías, mejores posiciones competitivas. En Colombia desde hace aproximadamente 20 años, dentro de la política de competitividad del gobierno nacional (a partir del informe monitor), se ha identificado la importancia de las relaciones entre empresas e instituciones conexas para mejorar los estándares y la eficiencia que se pueda lograr para mantener una posición competitiva en los mercados internacionales.

El papel del modelo económico chaebol en la participación de Corea del Sur en la OCDE

La presente investigación busca dilucidar el papel del modelo económico del chaebol en la participación de Corea del Sur en la Organización para la Cooperación y el Desarrollo Económico OCDE. Las investigaciones en torno al modelo chaebol y sus privilegios en Corea del Sur no han sido enfocadas directamente hacia el ámbito internacional y la influencia que puede tener allí dicho modelo. La investigación busca demostrar que el éxito del modelo económico del chaebol sirvió como incentivo para su entrada y participación activa en la OCDE, consiguiendo de esta forma no solo el establecimiento de una cooperación económica con sus miembros, sino un prestigio y reconocimiento frente a la Comunidad Internacional. Para el desarrollo de esta investigación de tipo cualitativo, se utilizarán fuentes de segundo y tercer grado para llevar a cabo un análisis documental de textos, pertinente para su desarrollo.

Entendiendo un programa de reparación: reconstrucción del proceso de creación e implementación de familias en su tierra – FEST– El caso del municipio de La Palma, Cundinamarca

A partir de la reconstrucción del proceso de creación e implementación del programa presidencial para la reparación a población desplazada Familias En Su Tierra, se exploran las dificultades y retos que enfrenta la Ley de Víctimas y Restitución de Tierras.

Vertical toleration as a liberal ideal

This paper argues that the direct, vertical toleration of certain types of citizen by the Rawlsian liberal state is appropriate and required in circumstances in which these types of citizen pose a threat to the stability of the state. By countering the claim that vertical toleration is redundant given a commitment to the Rawlsian version of the liberal democratic ideal, and by articulating a version of that ideal that shows this claim to be false, the paper reaffirms the centrality of vertical toleration in the Rawlsian liberal account of state-citizen relations.

The politics of the environment: a survey

The book is a collection of cutting edge essay on the politics of the environment covering and analysing important topics, such as the Kyoto protocol and deforestation, this book provides extensive coverage of all aspects of environmental politics. This unbiased survey is of interest to students, academics, business people and general researchers. Four sections present a thorough overview of current issues in the politics of the environment in historical perspective. The first section consists of essays written by a variety of academic and other experts on topics including Globalization: The Environment and Development Debate; The State, International Relations and the Environment; Environmental Movements; Mass Media and Environmental Politics; and The Ethical Dimensions of Global Environmental Change

The Emerging Civil Society in China and Its Impact on Democratization

Recent years have seen an emerging civil society in an authoritarian China. The authoritarian embrace of civil society challenges the conventional wisdom that civil society is closely linked to democracy. In Beijing, the rhetoric of civil society linked less to democracy than to modernization. However, does civil society development have any impact on democratization in authoritarian regimes? The thesis tries to provide a tentative answer by studying civil society and democratization in post-Mao China. As a result of economic development and political reforms, gradual political liberalization has marked a shift of state-society relations that gives rise to a certain degree of democratization and a growing civil society. The thesis uses a statistical correlation study to examine the relations between grassroots democratization and civil society development. The study concludes that civil society development may have contributed to democratization at the grassroots level but not on the national level. The impact of civil society on democratization depends on the political structure of the state and will remain limited unless the government allows for further state-led democratic openings.

governo eletrônico como propiciador da reforma do estado: o caso do leilão reverso na web para licitação pública

A presente dissertação versa sobre o uso da Tecnologia da Informação e Comunicação aplicada aos processos de gestão pública à luz dos conceitos de eficácia, eficiência e accountabítlity. Para tanto, este estudo se funda sobre dois marcos teóricos. O primeiro trata do desenvolvimento científico-tecnológico e suas implicações na construção de uma sociedade resultante da interação da microeletrônica, da informatização e da telecomunicação. O segundo diz respeito à reforma do Estado Brasileiro, num contexto em que se discute a necessidade de torná-lo mais ágil, flexível e mais responsável perante a sociedade. Metodologicamente, valemo-nos do estudo de caso múltiplo, no qual analisamos o Pregão Eletrônico utilizado pelo Governo Federal para aquisição de bens e serviços nos moldes do leilão reverso do mercado de flores de Amsterdã. Especificamente, trata-se do Pregão 21/2001, realizado pelo Ministério da Previdência e Assistência Social, para compra de medicamentos. Este estudo contempla não só os diferentes aspectos do comércio eletrônico, como o procurement, mas também descreve o processo tradicional de licitações públicas. Ao final, concluímos que a adoção da tecnologia da informação aplicada à gestão pública, em especial como ferramenta para aquisição de bens e serviços, mostrouse eficiente ao promover uma redução de custos, tanto dos processos governamentais, quanto dos produtos adquiridos, fato extremamente relevante se considerarmos a realidade orçamentária brasileira. Ficou também comprovada a sua eficácia, evidenciada pela redução do tempo necessário à realização do procedimento, uma vez comparado ao processo tradicional de licitações pública. Por outro lado, podemos afirmar que a iniciativa amplia o grau de transparência das informações do setor público brasileiro, reconfigurando as relações EstadoSociedade.